Gaballa Salem, Hlaing Kyaw M, Moursy Safa, Ahmed Ameenjamal, AlJaf Avan
Internal Medicine, LewisGale Medical Center, Salem, USA.
Internal Medicine, Lewisgale Medical Center, Salem, USA.
Cureus. 2020 Jun 9;12(6):e8527. doi: 10.7759/cureus.8527.
Focal seizures related to non-ketotic hyperglycemia (NKH) are rare in clinical practice. Plasma glucose levels are usually above 16.6 mmol/L and with normal or slightly elevated serum osmolality. The occurrence of focal seizures may be augmented by the absence of ketoacidosis. Electroencephalogram (EEG) during seizures usually confirms the diagnosis, however, the absence of epileptiform discharges does not rule out seizures. A non-ketotic hyperglycemia-associated occipital lobe seizure can manifest itself as color flashes, blurry vision with periodic confusion, and usually resolves with insulin treatment and rehydration. We are reporting a 65-year-old male patient who presented with intermittent confusion and left-sided visual disturbances, found to have a blood glucose of 33.7 mmol/L with a normal anion gap of 10 and calculated serum osmolality of 303 mOsm/L. The patient's visual disturbances responded very well to rehydration and insulin treatment.
在临床实践中，与非酮症高血糖（NKH）相关的局灶性癫痫发作很少见。血浆葡萄糖水平通常高于16.6 mmol/L，血清渗透压正常或略有升高。无酮症酸中毒可能会增加局灶性癫痫发作的发生。癫痫发作期间的脑电图（EEG）通常可确诊，然而，无癫痫样放电并不能排除癫痫发作。非酮症高血糖相关的枕叶癫痫发作可表现为色闪、伴有周期性意识模糊的视力模糊，通常通过胰岛素治疗和补液得以缓解。我们报告了一名65岁男性患者，该患者出现间歇性意识模糊和左侧视觉障碍，发现血糖为33.7 mmol/L，阴离子间隙正常为10，计算得出的血清渗透压为303 mOsm/L。该患者的视觉障碍对补液和胰岛素治疗反应良好。
